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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/resources/tools/reduce/antibiotic-faqs.docx
March 01, 2017 - Therefore, the diagnosis of UTI should always be a diagnosis of exclusion if the resident has a positive … urine culture diagnosis but does not have any UTI symptoms. … pointing out that you will help assess for any deterioration, and treating the urine in a resident without UTI
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www.qualitymeasures.ahrq.gov/hai/quality/tools/cauti-ltc/modules/resources/tools/prevent/clinical-faqs.html
March 01, 2017 - Evidence does not support use of methenamine hippurate (also called methenamine mandelate) to prevent UTI … urine specimen for culture should be obtained prior to initiating antimicrobial therapy for presumed CA-UTI … If an indwelling catheter has been in place for 2 weeks at the onset of CA-UTI and is still indicated … replaced to hasten resolution of symptoms and to reduce the risk of subsequent CA-bacteriuria and CA-UTI … Training also includes education about medications and their side effects, recognizing symptoms of a UTI
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/other-resources.pdf
June 01, 2021 - Other Resources 3
Toolkit from the AHRQ Nursing Home Antimicrobial Stewardship Guide: Suspected UTI … SBAR Toolkit
https://www.ahrq.gov/nhguide/toolkits/determine-whether-to-treat/toolkit1-suspected-uti-sbar.html … Tool from the AHRQ Nursing Home Antimicrobial Stewardship Guide Suspected UTI SBAR Toolkit:
Determine … T4-
Urinalysis_and_UTIs_Improving_Care_Final.pdf
Print and complete this AHRQ PDF form: Suspected UTI … management-of-patients-with-prosthetic-joints
https://www.ahrq.gov/nhguide/toolkits/determine-whether-to-treat/toolkit1-suspected-uti-sbar.html
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/communication-facilitator-guide.docx
June 01, 2021 - In this scenario, a family member worries that her aunt has a urinary tract infection, or UTI. … We performed a history and a full physical exam and she is not having symptoms of a UTI, nor does she … W has a UTI. He didn’t eat breakfast, and he is not acting like himself. … has a UTI. … Third, the Assessment: I am concerned that he may have a UTI. He seems very sick.
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www.qualitymeasures.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/education-bundles/urine-culturing/antibiotic-stewardship/case-study.html
March 01, 2017 - Valerie has a history of frequent urinary tract infections (UTI). … Over the last year she has been admitted to the hospital twice for UTI and has had multiple courses of … Johnny thinks his mother might have another UTI and wants her started on antibiotics right away.
1.
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/program-dev-slides.pptx
June 01, 2021 - Her son states the last time she had a dark urine she had a UTI. He wants her to be tested. … Her son states the last time she had a dark urine she had a UTI. He wants her to be tested. … Her son states the last time she had a dark urine she had a UTI. He wants her to be tested. … Her son states the last time she had a dark urine she had a UTI. He wants her to be tested. … Her son states the last time she had a dark urine she had a UTI. He wants her to be tested.
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/stewardship-slides.pptx
June 01, 2021 - the Intervention
Sustaining Stewardship
7
Example of Individualized Feedback
Prescriptions for UTI … indication documented
27 of 42 (64%) 8 of 8 (100%)
Urine culture ordered for residents’ indication of UTI … in concordance with local policies
Consider asking for provider feedback
Focus on common infections (UTI
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www.qualitymeasures.ahrq.gov/antibiotic-use/long-term-care/best-practices/posters.html
June 01, 2021 - Minimum Criteria for Initiation of Antibiotics for Suspected UTI, and When To Send a Urinalysis and Urine … (8 x 11, one-sided) (PDF, 202.3 KB)
Minimum Criteria for Initiation of Antibiotics for Suspected UTI
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/implementation/educational-bundles/urine-culturing/whento-order/urine-cultures.pptx
March 01, 2017 - reason to send a urine culture, particularly if the resident doesn’t have any specific symptoms of a UTI … or asymptomatic
Asymptomatic bacteriuria (ASB)
CAUTI requires presence of symptoms consistent with UTI … But smell, or cloudiness, etc., are not symptoms of UTI or CAUTI. … However, she doesn’t need a workup for UTI, at this point. … While her urine is cloudy, she is still doing well without any symptoms of UTI.
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/communication-slides.pptx
June 01, 2021 - W has a UTI. He didn’t eat dinner and he is not acting like himself. … W has a UTI. He didn’t eat dinner and he doesn’t seem like himself. … He should not be on this antibiotic—it was started in the hospital for a UTI, but he has been on it for
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www.qualitymeasures.ahrq.gov/hai/quality/tools/cauti-ltc/modules/resources/tools/reduce/antibiotic-faqs.html
July 01, 2017 - Therefore, the diagnosis of UTI should always be a diagnosis of exclusion if the resident has a positive … urine culture diagnosis but does not have any UTI symptoms. 4
How do you recommend we engage physicians … pointing out that you will help assess for any deterioration, and treating the urine in a resident without UTI
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/implementation/long-term-modules/module2/video-transcript-spanish.docx
April 21, 2014 - catheters, and one resident developed a C. diff. infection, after receiving antibiotics to treat her UTI … Tuvimos algunos casos de infecciones en las vías urinarias, o UTI, causadas por organismos resistentes … una residente contrajo una infección por C. diff., después de recibir antibióticos para tratar una UTI … un par de residentes que tuvieron infecciones por C. diff. mientras tomaban antibióticos para tratar UTI
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/antibiotic-patient-safety-facilitator-guide.docx
June 01, 2021 - nonspecific change in mental status or foul odor in urine are symptoms of a urinary tract infection or UTI … Sometimes education about the signs and symptoms of a UTI will help. … A positive urine culture without signs or symptoms of a UTI means the resident has asymptomatic bacteriuria … or asked a nurse to reassess the resident and find out if she was having any signs or symptoms of a UTI
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/implementation/educational-bundles/urine-culturing/antibiotic-stewardship/abx-stewardship-part2.pptx
March 01, 2017 - antibiotic stewardship is linked to infection prevention;
Explain how overtreating urinary tract infections (UTI … stewardship is linked to infection prevention;
Explain how over-treating urinary tract infections (UTI … about not ordering and collecting a urine culture unless a resident has signs or symptoms of a CAUTI or UTI
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/urine-culturing.pptx
April 01, 2022 - 4
CAUTI Signs and Symptoms6,11-12
Presence of symptoms suggestive of a urinary tract infection (UTI … an ICU Patient1
Questions to ask before culturing urine Yes No
Are there clear signs/symptoms of a UTI … Abbreviations: GU = genitourinary; UTI = urinary tract infection. … be considered only if used in conjunction with careful clinical evaluation for signs and symptoms of UTI … diagnosis missed
Implementing Culturing Stewardship28
Beliefs and Habits
Pyuria or bacteriuria = UTI
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/nhguide/4_TK2_T4-Common_Suspected_Infections_Tools_to_Improve_Communication_and_Decision_Making.ppt
May 01, 2014 - Example: One-third of residents receiving antibiotics for UTI are being treated for asymptomatic bacteriuria … One-third of residents receiving antibiotics for a “UTI” are asymptomatic. … chronic diseases, medications, and time of day can affect an older person’s temperature
*
Suspected UTI
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www.qualitymeasures.ahrq.gov/hai/quality/tools/cauti-ltc/modules/resources/tools/reduce/4-things.html
March 01, 2017 - * Go to CDC's January 2016 "Urinary Tract Infection (UTI) Event for Long-term Care Facilities," listed … Urinary Tract Infection (UTI) Event for Long-term Care Facilities .
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/family-slides.pptx
June 01, 2021 - Alvarez’s daughter
says that last time this
happened her mother was diagnosed with a UTI, and she requests … pretty uncomfortable, and I don’t think the pain she will feel is worth it when the suspicion for a UTI
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/implementation/educational-bundles/urine-culturing/antibiotic-stewardship/abx-stewardship-part1.pptx
March 01, 2017 - what actions you think should take place
Family says: “My Bobby always looks like this when he has a UTI … Antibiotics won’t help if he doesn’t have a UTI.
Antibiotics could hurt him (e.g., diarrhea). … In our first example, the family says: “My Bobby always looks like this when he has a UTI.” … And the nurse explains that antibiotics won’t help if he doesn’t have a UTI, that antibiotics could hurt
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/resources/tools/prevent/dos_and_donts.pdf
March 01, 2017 - Long‐term Care Facility (LTCF) Component Healthcare-Associated Infection Surveillance Module: UTI
Event